How Exercise Can Help Manage IBD Symptoms

Exercise is a key part of a healthy lifestyle for everyone, and finding time for moderate movement is recommended daily. However, for those living with Inflammatory Bowel Disease (IBD), exercising consistently may not always be possible. Fluctuating symptoms, including fatigue, abdominal pain, joint pain, bowel urgency, and unintentional weight loss, may make it difficult for some to find the motivation to get moving. 

Despite these challenges, incorporating some level of exercise as part of your wellness plan can be helpful, as research shows exercise to be beneficial for those with IBD. Exercise may help protect against disease progression and minimize disease-related complications in those with Crohn's disease or ulcerative colitis.¹ In one study, exercise was shown to help ease the symptoms of Crohn's and prevent relapses.² A higher activity level was correlated with decreased disease activity in patients with Crohn’s disease. However, the same result was not seen in those with ulcerative colitis. Additional noted benefits were improved self-image and quality of life.  

Similar results were found in a systematic review  published in 2021.³ A majority of the studies reviewed found physical activity had positive outcomes in improvement in quality of life, mental health, sleep quality, gastrointestinal symptoms, fatigue and cardiorespiratory fitness in those with IBD. Exercise was also correlated with reduced risk for the development of IBD and risk for future active disease. 

Benefits of Exercise

Physical activity has been shown to provide a multitude of benefits for physical and mental health. Exercise, in general, can help you maintain a healthy body weight, build muscle strength, support your bone health, boost your immune system, and help combat depression and anxiety. The following are a few benefits that may be particularly important for those with IBD. 

• Boosts the immune system- Many individuals with IBD take immunosuppressant medication or biologic agents to help manage their symptoms. Certain medications may weaken the individual’s immune system, making them more susceptible to other illnesses. Exercise has been shown to improve overall immune function to help individuals fight off common infections and other illnesses. 
• Improved bone density: Inflammatory bowel diseases are associated with decreased bone density and strength and a higher risk of osteoporosis due to several factors, including medication treatments such as steroids, malabsorption of nutrients, and the inflammation associated with the disease (4). Weight-bearing exercises and resistance training can help keep bones strong and improve bone mineral density. 
• Decreased Joint pain - Joint pain, including arthritis, is one of the most common extraintestinal symptoms experienced in IBD.⁵ Flexibility exercises, such as stretching and yoga, focus on lengthening the muscles to improve flexibility and decrease stress on the joints. 
• Easing GI Symptoms - Moderate exercise has been shown to positively affect many intestinal symptoms, such as constipation, bloating, abdominal pain, and cramping.¹ 
• Reduced Risk of Colorectal Cancer - Moderate exercise is associated with a reduced risk of colorectal cancer, with an average risk reduction of 20%-25%.¹  This is of particular importance for those with IBD, who may be at higher risk due to long-standing colonic inflammation. 
• Improved Quality of Life- Individuals living with IBD tend to report higher rates of depression, anxiety, and levels of stress.⁵ Exercise can positively affect all these areas of life quality, including improved mood and overall outlook, reduced fatigue, improved sleep and energy levels, and improved perceived feelings of physical well-being.  

With all the benefits of physical activity, light to moderate exercise should be incorporated into your IBD management plan as your health allows. It is important to go slow and find a good balance of activity that gives you the benefits of exercise without causing an increase in your symptoms. Always work with your healthcare team before starting a new exercise regimen to ensure the activity and level of intensity is a good fit for you. 

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References:

1. Engels M, Cross RK, Long MD. Exercise in patients with inflammatory bowel diseases: current perspectives. Clin Exp Gastroenterol. 2017;11:1-11. Published 2017 Dec 22. doi:10.2147/CEG.S120816
2. Lamers CR, de Roos NM, Koppelman LJM, Hopman MTE, Witteman BJM. Patient experiences with the role of physical activity in inflammatory bowel disease: results from a survey and interviews. BMC Gastroenterol. 2021;21(1):172. Published 2021 Apr 14. doi:10.1186/s12876-021-01739-z
3. Davis SP, Crane PB, Bolin LP, Johnson LA. An integrative review of physical activity in adults with inflammatory bowel disease. Intest Res. 2022;20(1):43-52. doi:10.5217/ir.2020.00049 
4. Lima CA, Lyra AC, Mendes CMC, et al. Bone mineral density and inflammatory bowel disease severity. Braz J Med Biol Res. 2017;50(12):e6374. Published 2017 Oct 19. doi:10.1590/1414-431X20176374
5. Jones K, Kimble R, Baker K, Tew GA. Effects of structured exercise programmes on physiological and psychological outcomes in adults with inflammatory bowel disease (IBD): A systematic review and meta-analysis. PLoS One. 2022;17(12):e0278480. Published 2022 Dec 1. doi:10.1371/journal.pone.0278480

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